Individual provider Active NPI

Odalis Graveran

  • Behavior Technician
  • Hialeah, FL
National Provider Identifier
1487170932
Registry record updated Aug 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
7512 W 20TH Ave Apt 101
Hialeah, FL 33016-5554
Phone
(786) 718-5455
NPI assigned
Aug 16, 2017
Last updated
Aug 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X NU Primary

Addresses

Primary practice location

7512 W 20TH Ave Apt 101
Hialeah, FL 33016-5554

Mailing address

7512 W 20TH Ave Apt 101
Hialeah, FL 33016-5554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502928000000",
    "number": "1487170932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7512 W 20TH AVE APT 101",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7512 W 20TH AVE APT 101",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165554",
            "telephone_number": "786-718-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVERAN",
        "first_name": "ODALIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2017-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.